MONTELUKAST
Manner of administration:Oral
Restriction (Streamlined authority code: 15643)
Indication: Asthma
Treatment phase: First-line prevention
Restriction (Streamlined authority code: 15644)
Indication: Asthma
Treatment phase: Prevention of condition
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 2 | Max qty units: 56 | # of repeats: 5 | DPMQ: $22.40 | Max safety net: $23.88 | General Patient Charge: $25.00 |
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Manner of administration:Oral
Restriction (Streamlined authority code: 6674)
Indication: Asthma
Treatment phase: First-line prevention
Restriction (Streamlined authority code: 7781)
Indication: Asthma
Treatment phase: Prevention of condition
Quantities & Cost
| Max qty packs | Max qty units | # of repeats | DPMQ | Max safety net | General Patient Charge |
|---|---|---|---|---|---|
| Max qty packs: 1 | Max qty units: 28 | # of repeats: 5 | DPMQ: $18.09 | Max safety net: $19.57 | General Patient Charge: $22.36 |
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